Provider Demographics
NPI:1710005822
Name:TAP RX LLC
Entity Type:Organization
Organization Name:TAP RX LLC
Other - Org Name:PROCARE LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:631-843-0500
Mailing Address - Street 1:270 S SERVICE RD STE 25
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2399
Mailing Address - Country:US
Mailing Address - Phone:631-359-9711
Mailing Address - Fax:631-843-0500
Practice Address - Street 1:270 S SERVICE RD STE 25
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2399
Practice Address - Country:US
Practice Address - Phone:631-843-0500
Practice Address - Fax:631-843-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028192333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3353719OtherNCPDP
NY028132Medicaid
NY5894210001Medicare NSC